Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Oral surgery > 7. Types of anesthesia in oral and maxillofacial surgery. Premedication and general anesthesia. > Flashcards

7. Types of anesthesia in oral and maxillofacial surgery. Premedication and general anesthesia. Flashcards

1
Q

Types of Anesthesia

A
  • Local
  • General
  • Neuroleptanasthesia
  • Sedation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Premedication in the context of maxillofacial surgeries

A
  • Administration of medications with specific pharmacological actions before surgery or anesthesia
  • Enhances patient safety and comfort during the surgical procedure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Factors that influence the selection and dosage of premedication drugs

A
  • Patient’s age
  • Weight
  • Physical status
  • Type of anesthesia
  • Level of anxiety and fear
  • Pre-existing medical conditions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How timing of premedication determined

A
  • Factors such as => onset
  • Peak effect
  • Duration of action
  • Route of administration
  • Ensures medication =>achieves intended effects at the appropriate time
  • Optimises its efficacy in preparing the patient for anesthesia and surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Used for learning objectives of premedication

A

10 A’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

10 A’s for premedication

A
  1. Anxiolysis-Relief of anxiety
  2. Analgesia
  3. Amnesia of preoperative events
  4. Antisialogogue effects-reduction in salivary and bronchial secretions
  5. Anti-emetic effect
  6. Anti-acid effect-reduction in stomach acid
  7. Allergies
  8. Antiautomatic-parasympathetic/Sympathetic reflexes care-Vagolytic actions
  9. Anaesthetic induction
  10. Antibiotic regime
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Routes of administration for premedication

A
  • Enteral
  • Parenteral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Enteral routes of administration

A
  • Oral
  • Rectal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Parenteral routes of administration

A
  • Intranasal
  • Intramuscular
  • Intravenous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Premedication drug groups

A
  • Benzodiazepines
  • Opoids
  • Barbituates
  • Phenothiazines
  • Butyrophenones
  • Anticholinergics
  • Alpha adrenoceptor antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

First Cranial nerve

A

-Olfactory nerve(smell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Second Cranial nerve

A

Optic nerve (sight)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Third Cranial nerve

A

Oculomotor nerve (Orbital muscles for eye movement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fourth Cranial nerve

A

Trochlear nerve (Orbital muscles for eye movement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fifth cranial nerve

A 
Trigeminal nerve( Motor: movement of the **jaws** and **muscles of mastication**
Sensory: sensation of feeling for the **face, teeth, and periodontal ligaments**, and anterior two thirds of the **tongue**)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sixth Cranial nerve

A

Abducens nerve (Orbital muscles for eye movement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Seventh Cranial nerve

A

Facial Nerve ( Motor: to the muscles of facial expression
Sensory: taste to anterior two-thirds of tongue
Secretory: to submandibular and sublingual glands)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Eighth Cranial nerve

A

Auditory Nerve(Sense of hearing, position, and balance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tenth Cranial nerve

A

Vagus nerve( Pharyngeal and laryngeal movements: digestive tract)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Eleventh Cranial Nerve

A

Accessory nerve(Neck movements: sternocleidomastoid and trapezius muscles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Twelfth Cranial nerve

A

Hypoglossal nerve ( Motor: tongue movement (muscles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Largest cranial nerve

A

Trigeminal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Trigeminal nerve divisions

A
  • Division I- Ophthalmic
  • Division II- Maxillary nerve
  • Division III- Mandibular nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ophthalmic and maxillary nerve are

A

Afferent only(sensory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Mandibular nerve is
Efferent (motor) and afferent (sensory)
26
Ophthalmic Nerve origin
exits skull through **superior orbital fissure** on the superior surface of the **orbit**
27
Ophthalmic Nerve branches
* *-Lacrimal nerve** (smallest), * *-Frontal nerve**(largest ) - **Nasociliary** **nerve**
28
Ophthalmic Nerve sensations
-Touch, pain, pressure -Skin of upper third of **face** (**forehead** and anterior **scalp**, and the skin around the **eyeball**, **eyelid** and **nose**, and part of the **nasal mucosa**) -**Maxillary sinus**
29
Maxillary nerve sensations
touch, pain, pressure, and temperature
30
The maxillary nerve innervates
- Middle third of **face** and the **palate** - **Pulp** of all maxillary teeth
31
The maxillary nerve exists the brain through
**Foramen rotundum**
32
Four important branches of the Maxillary nerve
* -Pterygopalatine* * -Posterior superior alveolar (PSA)* * -Infraorbital* * -Zygomatic nerve*
33
Which branch of the Pterygopalatine Nerve passes through the greater palatine foramen and what does it become?
**Descending palatine nerve** becomes **Greater palatine nerve**
34
Greater palatine nerve innervation
- Mucosa of posterior part of **hard palate** - Palatal gingiva of **posterior teeth**
35
Nerves that arise posterior to the Greater palatine foramen
**Middle** and **Posterior** (lesser) **palatine nerves** enter the palate through the **lesser palatine foramen** to spread posteriorly to supply the ***tonsils*** and *mucosa* of the **soft palate**
36
Long branch of Pterygopalatine nerve that runs along roof of nasal cavity
- **Nasopalatine nerve** - Runs along **nasal septum**-\>enters bone of palate-\>arises in anterior palate through **incisive foramen**
37
Nasopalatine nerve Innervates
-Soft tissue of the **nasal septum** and **gingiva** **-Palatal soft tissue** lingual to the anterior teeth
38
The right and left nasopalatine nerves combined with the greater palatine nerves innervate
Soft tissues of entire **hard palate**
39
-Once in maxillary bone the posterior superior alveolar nerve supplies
**-Maxillary molars**(except mesiobuccal root of maxillary first molars) - Alveolar bone - PDL - **Facial gingiva** of maxillary molars - **Mucosa** of part of **maxillary sinus** - **Cheek mucosa** next to maxillary molars
40
Within the infraorbital canal the infraorbital nerve gives off two branches
**Middle superior alveolar** nerve(MSA) and **Anterior superior alveolar** nerve (ASA)
41
Branches of middle superior alveolar nerve supply
- **Maxillary premolars** and **mesiobuccal root** of maxillary first molar - Alveolar bone - Periodontal ligaments - Facial gingiva - In maxillary premolar region and part of maxillary sinus
42
Second branch given off by the infraorbital nerve while in the infraorbital canal
Anterior superior alveolar nerve
43
Anterior superior alveolar nerve supplies
- Pulp - Supporting alveolar bone - Periodontal ligaments - Facial gingiva - Of **maxillary anterior teeth** and part of **maxillary sinus**
44
Infraorbital nerve exits from
Infraorbital foramen
45
After exiting from the infraorbital foramen, the infraorbital nerve splits into terminal branches that innervate
- Skin and mucosa of side of nose**(nasal nerve)** - Skin and mucosa of lower eyelid**(palpebral nerve)** - Skin and mucosa of upper lip, facial gingiva of maxillary premolars and facial gingiva of anterior teeth**(labial nerve)**
46
The zygomatic nerve supplies
-Skin of **temporal region** and lower part of **orbit**
47
Division III of trigeminal nerve
Mandibular nerve
48
Mixed nerve (sensory and motor) and only motor portion of trigeminal nerve
Mandibular nerve
49
Motor fibres of mandibular nerve supply
-8 **muscles of mastication** **-Mylohyoid muscle** -Anterior belly of the **digastric muscle**
50
Sensory fibres of mandibular nerve supply
- Touch, pain, pressure and temperature - Lower third of **face** - Floor of **mouth** - Anterior two thirds of **tongue**(not taste) - **Mandibular teeth**
51
The mandibular nerve exits the neurocranium through
Foramen ovale
52
Four main branches of mandibular nerve
- **Auriculotemporal nerve** - **Buccal nerve** - **Lingual nerve** **- Inferior alveolar nerve**
53
Auriculotemporal nerve supplies
- Pain and proprioception fibres to the **TMJ** - Skin of **outer ear** - Lateral aspect of **skull** and **cheek**
54
Buccal nerve innervates
-Mucosa and skin of **cheek** in area of **mandibular molars** up to corner of mouth **-**Sometimes **second premolars**
55
Lingual nerve innervation
- Touch, pain, pressure, temperature(not taste) - **Dorsal**(top) and **ventral**(bottom) surface of **anterior two thirds of the tongue** and adjacent tissues(floor of mouth, inner surface of mandible and lingual gingiva of entire mandible)
56
Once the Inferior alveolar nerve enters the mandible through the mandibular foramen it is in the
- **Mandibular canal** - Gives off **dental branches** that spread through trabecular bone of mandible - Enter **apical foramen** of all **mandibular molars** and **premolars** - Innervates **PDL** and **alveolar processes** of those teeth
57
Within the mandibular canal, the Inferior alveolar nerve splits near the roots of the premolars to become
-**Mental** and **incisive nerves**
58
Incisive nerve supplies
- Mandibular **incisor** and **canine** teeth - Their **PDLs** and **alveolar processes**
59
The mental nerve branch of the Inferior alveolar nerve exits from the body of the mandible through
-Mental foramen
60
Mental nerve supplies
- Facial gingiva of the **mandibular incisors, canines,** and **premolars** - Mucosa and skin of the **lower lip** and **chin** on that side up to the midline
61
Motor(efferent) branches of mandibular nerve supply to muscles of mastication
- **Masseteric nerve**-(Masseter muscle and TMJ) - **Posterior and anterior temporal nerves**(Temporalis muscle) - **Medial pterygoid nerve**(medial pterygoid muscle) **-Lateral pterygoid nerve**(lateral pterygoid muscle)
62
Facial nerve fibres are
Mixed(sensory and motor)
63
Efferent fibres of facial nerve innervate
- **Muscles of facial expression** - **Posterior belly of digastric muscle** - **Stylohyoid muscle** - **Stapedius muscle**
64
Secretory fibres of Facial nerve innervate
-Secretions from **Sublingual**(Under mucosa in floor of mouth superior to mylohyoid muscle) and **Submandibular glands(**Located in submandibular fossae on medial surface of mandible inferior to mylohyoid muscle)
65
The Chorda tympanic fibres of the facial nerve join with
-**Lingual nerve** and supply sense of taste to anterior two thirds of **tongue**
66
The glossopharyngeal nerve type
- Mixed nerve(**sensory** and **motor**) - Supplies parts of **tongue** and **pharynx**
67
Afferent fibres of Glossopharyngeal nerve supply
-Taste and sensation to **posterior one third of tongue** **-**Sensation to **mucosa of pharynx and tonsils**
68
Motor nerves of the Glossopharyngeal innervate
**Stylopharyngeus muscle** of the pharnyx
69
Secretory fibres of the Glossopharyngeal nerve innervate
Parotid gland
70
Hypoglossal nerve innervation
- Descends steeply to muscles that move **tongue** - **Genioglossus, styloglossus, hyoglossus**
71
Inferior Alveolar nerve block -Halstead Technique
- Targets **Inferior alveolar nerve** - Anaesthetises * Teeth and bone on one side of mandible * Soft tissues on buccal aspect anterior to mental foramen * Soft tissues of lower lip * Reflected and attached gingivae from premolar teeth to midline * Lingual nerve-anterior two thirds of tongue - Injection at **pterygotemporal space** on medial aspect of ramus(region of mandibular foramen)
72
Halstead Technique procedure
- Long 35mm needle no narrower than 27 gauge used - Patient mouth open wide - Thumb on coronoid notch - Index finger extraoral at height of posterior border of ramus - Syringe passed across lower premolars - Penetration of syringe between external oblique ridge and pterygomandibular raphae - Height of penetration halfway between thumbnail - Advance needle until bone contacted(25mm of needle insertion) - Withdraw, aspirate and inject 1.5-2 ml of solution
73
Gow-gates technique
- More superior than Halstead technique(more branches of mandibular nerve affected) - Anaesthetises inferior alveolar nerve, lingual, long buccal, mylohyoid and auriculotemporal nerves - Mouth wide open - Parallel plane between corner of mouth and intertragal notch used as guide - Syringe passed along maxillary canine of opposite side and across palatal cusps of maxillary second molar on injected side - When bone of condyle contacted, slight withdraw, aspiration and injection of 2ml solution - More effective than Halstead approach
74
Akinosi-Varizani Technique
- Anaesthetises inferior alveolar nerve, Lingual nerve, mylohyoid nerve and occasionally long buccal nerve - Administered with patients mouth closed - Long needle no narrower than 27 gauge used - Syringe introduced intraorally at level of mucogingival junction of maxillary molars - Syringe advanced to medial surface of ramus where insertion into occurs - Hub of needle adjacent to distal surface of maxillary second molar→ Needle should be in correct place for injection - Aspiration and injection of 2ml solution slowly
75
Mental and incisive nerve block
-Anaesthetises * teeth and jaws from premolars to anteriors * Soft tissues of lower lip and chin to midline on one side * First molar in some cases - Usually intraoral but extraoral approach can be used - Needle inserted at depth of buccal sulcus between premolar teeth at apices→ Targeting mental foramen - 1.5ml solution injected and tissues massaged to encourage entry of solution into foramen
76
Long buccal nerve block
- Anaesthetises the buccal gingivae and mucosa and part of the cheek in the mandibular molar region - 0.5ml solution in region of coronoid notch of mandible
77
Maxillary Nerve block
-Anaesthetises * Teeth and bone of maxilla on one side * Buccal and palatal mucosa * Skin of lower lip, lower eyelid and lateral aspect of the nose - Intraoral and extraoral approaches - Intraoral methods-**Tuberosity approach** and **greater palatine foramen approach**
78
Tuberosity approach
- Solution deposited high in buccal sulcus → distal surface of maxillary second molar - Angle of 45 degrees to depth of 30.. mm - 2 ml solution deposited
79
Infraorbital nerve block technique
- ION approached from either intraoral or extraoral sides - Intraoral approach→ long needle into buccal sulcus(between premolar teeth) →Advance towards infraorbital foramen(palpated extraorally) →1-1.5ml solution deposited at 16mm following aspiration
80
Infraorbital nerve block targets
- Teeth and associated bone from second premolar to central incisor - Adjacent gingivae of the teeth - Mucosal and skin of one half of upper lip - Part of skin of nose affected
81
Greater palatine foramen approach
- Mouth wide open=\> greater palatine foramen identified →depression medial to second maxillary molar) distal surface) - Insertion into pterygopalatine fossa(via greater palatine foramen) - Needle angle 45 degrees superiorly and posteriorly to depth of 30 mm - 2 ml solution injected
82
Nasopalatine nerve block
- Anaesthetises tissue of hard palate adjacent to incisor teeth - 0.2-0.5 ml solution adjacent to incisive papilla
83
Injection in parotid gland results in
-Facial nerve→ Hemifacial paresis
84
Length of Halstead Anaesthesia
- Teeth→ 45mins - Soft tissues→ up to 3 hours
85
Weisbrem technique
* Open mouth as wide as possible * Syringe on opposite premolars * Advanced to lateral edge of plica pterygomandibularis(pterygomandibular fold) * Needle 0.5 cm below chewing surface of maxilllary third or second molar=> * In absence of teeth 1.5 cm from alveolar crest * Needle advanced to contact bone, withdrawn, aspiration and injection of 1.5ml * On withdrawl, rest of solution deposited for lingual nerve * Anesthesia after 5-7 minutes
86
Nitrous oxide, and how it functions in dental anesthesia
*Aka laughing gas * Crosses the alveoli of the lungs and dissolves into the passing blood=> brain * Dissociated and euphoric feeling * Used in combination with oxygen.
87
General anesthesia drugs commonly used in dentistry, and their purpose
* Midazolam * Ketamine * Propofol, and fentanyl * Put a person in a twilight sleep or render them completely unconscious and unaware of pain
88
Purpose of combining nitrous oxide with oxygen during its administration
* Ensures patient receives an adequate supply of oxygen while experiencing the sedative and euphoric effects of nitrous oxide

Oral surgery (106 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions